Can the Prognosis of Cardiac Resynchronization Therapy Be Predicted by Gated SPECT?. (October 2015)

• Record Type: Journal Article
• Authors: Qin, Shengmei; Shi, Hongcheng; Su, Yangang; Chen, Shuguang; Pan, Wenzhi; Ge, Junbo
• Is Part Of: Clinical nuclear medicine. Volume 40:Number 10(2015)
• Publication Date: 2015-10
• Subjects: Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000000912
• Languages: English
• ISSNs: 0363-9762

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Purpose</title> <p>The aim of this study was to evaluate the role of gated myocardial perfusion SPECT (GMPS) phase parameters (phase SD and histogram bandwidth) in predicting the short-term response to cardiac resynchronization therapy (CRT) as left ventricle (LV) remodeling and the long-term effect as all-cause mortality or cardiac transplantation and hospitalization for heart failure.</p> </sec> <sec> <title>Patients and Methods</title> <p>This prospective observational study included 63 consecutive patients undergoing CRT from May 2008 to April 2014. Before CRT, patients underwent evaluation of New York Heart Association functional class, standard 12-lead ECG, <sup>99m</sup>Tc-MIBI GMPS, and 2-dimensional echocardiography. The patients were grouped according to complete left bundle-branch block (CLBBB). Follow-up was done every 6 months after pacemaker implantation. The short-term end point was reverse LV remodeling in 6 to 12 months follow-up, and the long-term primary end point was all-cause mortality or cardiac transplantation. The secondary end point was hospitalization for heart failure.</p> </sec> <sec> <title>Results</title> <p>Reverse LV remodeling showed in 60.9% (39/63) patients (74.5% CLBBB [35/47] vs 25.0% non-CLBBB [4/16], <italic>P</italic> < 0.001). Phase SD less than 55 degrees, CLBBB, and left atrium diameter were independent predictive factors for reverse LV remodeling. At a median follow-up of 39.76 months, there were 17 deaths and 2 transplantations (17.0% CLBBB vs 68.8% non-CLBBB, <italic>P</italic> < 0.001). Seventeen patients required hospitalization more than once for heart failure, and 2 underwent heart transplantation (14.9% CLBBB vs 62.5% non-CLBBB, <italic>P</italic> < 0.001). Multivariate logistic regression showed that only CLBBB was an independent predictive factor for both end points.</p> </sec> <sec> <title>Conclusions</title> <p>The GMPS parameters were not independent predictive factors for all-cause mortality or cardiac transplantation and hospitalization for heart failure.</p> </sec> </abstract>